最新刊期
卷 46 ， 期 10 ， 2023
- 摘要：Pulmonary nodules are lung imaging manifestations that lack typical respiratory symptoms, such as cough, expectoration, asthma, et al. In the evaluation of the efficacy of traditional Chinese medicine (TCM) in the treatment of pulmonary nodules, it is difficult to use the symptom-based TCM pattern score evaluation system. It is necessary and urgent to establish a TCM clinical efficacy evaluation system for pulmonary nodules. Following the authoritative guidelines for the diagnosis and treatment of pulmonary nodules in China and abroad, this paper summarizes and puts forward an evaluation of the clinical efficacy of TCM for pulmonary nodules on the basis of a large number of clinical research practices. This evaluation method takes the total effective rate as the main efficacy index, that is, comprehensively considering the change rate of cross-sectional area and (or) diameter change, and malignant sign change, the efficacy is divided into five levels: cured, significantly efficacious, effective, stable, and deteriorating, and the total effective rate (%)=(cured cases + significantly efficacious cases + effective cases)/total cases × 100%. Secondary efficacy indexes include average diameter change, average cross-sectional area change, risk conversion rate, malignant probability change calculated by Mayo model. The evaluation period is 3 and 6 months. In short, the establishment of a multi-dimensional efficacy evaluation system based on changes in nodule diameter or cross-sectional area is conducive to providing standardized, systematic and high-level evidence for clinical research on the treatment of pulmonary nodules with TCM.关键词：pulmonary nodules;clinical efficacy evaluation;diameter;cross-sectional area;risk;Mayo model;malignant signs
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发布时间：2023-11-06 - 摘要：In clinical reports, patients with pulmonary nodules have been treated successfully with traditional Chinese medicine (TCM). However, due to the lack of pathological data on the reduction or disappearance of pulmonary nodules, whether TCM is effective in treating inflammatory nodules or early-stage cancer nodules remains controversial. The evaluation of the efficacy of TCM intervention in pulmonary nodules is often based on metrics obtaining through computed tomography(CT) such as nodule diameter, CT value, and tumor model integration, which do not comprehensively represent the current status of pulmonary nodule progression. CT radiomics technology provides more comprehensive data for the qualitative diagnosis of ground glass pulmonary nodules. By analyzing the CT histogram parameters using artificial intelligence technology, such as graphics (layers and wave shape), entropy, volume, mass, and skewness, benign and malignant nodules can be identified. It can also be used for evaluating the progress of the nodules, as it is dynamic, intuitive, and non-invasive, which maybe provide a new method for objectively evaluating the efficacy of TCM in treating pulmonary nodules.关键词：pulmonary nodules;ground glass nodules;radiomics;histogram;efficacy evaluation
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发布时间：2023-11-06 - 摘要：Patients with pulmonary nodules are often found to have multiple extrapulmonary nodules, such as thyroid nodules and breast nodules, which are often accompanied by anxiety, depression, and other mental disorders and sleep disorders. Based on "holism of physique and spirit", this article discusses the relationship between disorders of five emotions, such as anxiety and depression that affect the qi movement and the function of zangfu, and the complication of pulmonary nodules with extrapulmonary nodules. The five zang-organs store the five spirits and transform the five emotions. Disorders of five emotions lead to the body’s qi counterflow, resulting in the accumulation of dampness, phlegm, stasis, which transform into the nodules; disorders of five emotions for a long time damage to the zangfu’s qi and blood, depletion of the five zang-organs of the real energy, then dampness, phlegm, stasis accumulate and transform into toxins, which leads to carcinoma. Pulmonary nodules complicated by extrapulmonary nodules are the result of emotional disorders and imbalance of the body’s internal environment in the localized areas of the physique, which is a disease of both physique and spirit and the target of gathering of dampness, phlegm and blood stasis. Treatment should be based on the method of regulating physique and spirit together, treating qi and blood together, replenishing the deficiency and dissipating the nodules, detoxifying and suppressing the cancer, together with the method of spiritual guidance and regulating the emotions and feelings, in order to achieve the state of harmony of physique and spirit, disease can be cured.关键词：holism of physique and spirit;pulmonary nodules;disorders of five emotions;anxiety;depression;regulating physique and spirit together
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发布时间：2023-11-06
Special Theme: TCM Prevention and Treatment of Pulmonary Nodules
- 摘要：The proposition "lung is connected to the large intestine and the large intestine corresponds to the skin" is important in the visceral manifestation theory of the lung, which describes the physiopathological internal and external correspondence among the lung, large intestine, and skin. It is widely used in the treatment of various intractable diseases of the lungs, large intestine, and skin system, including "lung disease treatment by the intestine" "intestinal disease treatment by the lung" "skin disease treatment by the lung" "skin disease treatment by the intestine", and other forms of homotherapy and mutual treatment. In this paper, the theoretical implications of the correspondence of zang-fu organs such as "lung is connected to the large intestine" "lung is associated with the skin and hair" and "the large intestine corresponds to the skin" are explained from the perspectives of systematic thinking, subject-object integration, and logical reasoning, and the logical relationship of mutual "lung-intestine-skin" correspondence is clarified. Based on the two-way interaction network of the "lung-intestine" axis、"lung-skin" axis and the "intestine-skin" axis, it is of great significance to explore its biological mechanism, enrich and expand the connotation of the concept of "skin" in traditional Chinese medicine, and construct a new treatment model for "lung-intestine-skin" syndrome based on "state-target combination". The present paper provides important research ideas and reveals the significance of syndrome differentiation and treatment method .关键词：the lung being connected to the large intestine;the large intestine corresponds to the skin;lung-gut axis;lung-skin axis;gut-skin axis
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发布时间：2023-11-06 - 摘要：Through the study of the relevant content of "dampness obstructing heat and suppressing heat" in the original text of Wenre Lun, it was found that the literature mostly use fragrant and dry, salty and cold, or bitter and cold medicinals for treatment, which is inconsistent with the original ideas of "eliminating dampness and dispelling heat" and "preventing its dryness". Therefore, beginning from the clinical manifestations of dampness obstructing heat and suppressing heat, and the definitions of "eliminating", "eliminating dampness", and "eliminating dampness and dispelling heat", combined with various perspectives, the syndrome differentiation and treatment content of dampness obstructing heat and suppressing heat was analyzed. The clinical manifestations of the syndrome of dampness obstructing heat and suppressing heat, in addition to a deep red tongue with white fur, may also include symptoms such as aversion to cold, fever, epigastric fullness, unconsciousness, dry tongue, thick yellow fur, greasy fur, and slippery pulse, which represent disorders of weifen, qifen, and yingfen. The disease location is wide-ranging, mainly involving the lung, spleen, and stomach. The treatment strategy is to eliminate dampness and dispel the heat with medicinals acrid, bitter, sweet and bland in flavour. The goal is to open up the dampness and heat with acrid and bitter medicinals, and percolating and draining dampness with sweet and bland medicinals is only one of the available treatment methods. In clinical practice, caution should be exercised when using fragrant and dry, salty and cold, or bitter and cold medicinals to avoid misunderstandings and misuse.关键词：eliminating dampness and dispelling heat;dampness obstructing heat and suppressing heat;syndrome differentiation and treatment research;acrid medicinals open and bitter medicinals promote descent
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发布时间：2023-11-06 - 摘要：The definition of stroke has changed considerably from ancient times to the present. The "stroke formula" established by Zhang Zhongjing has also undergone a process of affirmation, denial, and reaffirmation in its historical development. Currently, classical prescriptions are increasingly valued in the academic community, and it has been recognized that it is important to clarify the connotation and clinical application of classical formula. This article discusses the original meaning of "three formulas for stroke(Houshiheisan, Fengyin Decoction and Gujin Luyan Xuming Decoction)" and its connotation in Synopsis of the Golden Chamber. We list its historical contributions to the ancient principles for the treatment of stroke and discuss its widespread use in modern clinical practice. We found that its ancient principles and its modern use have some characteristics in common. This analysis of the "three formulas for stroke" concept will help to lay foundation for further clinical practice and relevant research and to expand the ideas and method for the treatment of stroke.关键词：stroke;Synopsis of the Golden Chamber;Houshiheisan;Fengyin Decoction;Gujin Luyan Xuming Decoction
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发布时间：2023-11-06 - 摘要：Postmenopausal osteoporosis is a bone metabolism disease that occurs in women after menopause and is categorized in Chinese medicine as "bone flaccidity" and "bone erosion". In recent years, postmenopausal osteoporosis has been closely associated with studies on intestinal flora. Based on the generating-restricting relationship between the five elements in Chinese medicine and LI Dongyuan’s view that "when the spleen is sick, water-dampness flows downward to the kidney, and when the earth restricts water, the bones become weak and feeble, resulting in bone erosion" in Piwei Lun, this article puts forward the theory that "earth restricting water" causes flaccidity. Building upon this theoretical foundation, we explore the roles of spleen deficiency, kidney deficiency, and phlegm turbidity in the pathologic process of postmenopausal osteoporosis, while highlighting the role of intestinal flora as a mediator in this process. We propose a comprehensive therapeutic approach involving the interplay of "spleen earth-intestinal flora-kidney water-postmenopausal osteoporosis", which offers a new perspective for the clinical treatment of postmenopausal osteoporosis.关键词：earth restricting water;intestinal flora;postmenopausal osteoporosis;Piwei Lun
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发布时间：2023-11-06
Theoretical Studies
- 摘要：ObjectiveAimed to establish a stable doxorubicin-induced cardiactoxicity (DIC) animal model by observing the macroscopic signs and microscopic indexes of DIC in mice, to establish a stable animal model of DIC combined with disease and syndrome, and to explore the regularity of traditional Chinese medicine(TCM) syndrome changes in DIC mice model.MethodsSPF grade C57 BL/6 wild-type mice randomly devided into the normal group(n=10) and the model group(10=10), the model group mice were injected with adriamycin 5 mg/kg by the tail vein injection, and the normal group were injected with normal saline, once a week for 4 weeks. Echocardiography and pathological staining of HE, Masson and TUNEL were used to evaluate the model. The general condition of mice was observed every week, and the RGB value ratio of tongue and exhaustive swimming time bearing weight were recorded. The serum levels of lactate dehydrogenase (LDH), creatine kinase isoenzyme (CK-MB), malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO) and tissue adenosine triphosphate (ATP) were detected by biochemical method .ResultsCompared with the normal group, from the first week, the mice in the model group showed listlessness, increased activity wheezing, decreased activity, decreased body weight (P<0.01), and shortened exhaustive swimming time (P<0.05). From the 2nd week, the r value of tongue was decreased (P<0.01), while the g value and b value were significantly increased (P<0.01). In addition, compared with the normal group, the levels of LDH, CK-MB and MDA in the model group were increased (P<0.01), and the contents of SOD, NO and ATP were decreased (P<0.01).ConclusionIn the DIC mice model, macroscopic signs and syndromes change with time and disease progression. The result of microscopic blood biochemistry and macroscopic signs showed that the DIC mice model appeared qi deficiency syndrome at week 1, and gradually evolved into qi deficiency and blood stasis at week 2-4.关键词：doxorubicin-induced cardiotoxicity;TCM syndromes;qi deficiency and blood stasis;cardio-oncology;mice
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发布时间：2023-11-06 - 摘要：ObjectiveWe aimed to evaluate the antidepressant effect of the Chinese medical compound formula—Sangju Jieyu Formula (SJJY) and the underlying mechanism.Methods(1) Behavioral despair model experiment. The model was established through tail suspension, forced swimming and spontaneous locomotro activity. Mice were divided into the control group, the duloxetine group (10 mg/kg in the tail suspension test [TST], 20 mg/kg in the forced swimming test [FST] and the spontaneous locomotor activity test [SLAT] ), and the SJJY groups (267.4, 534.8, and 1 069.5 mg/kg). The antidepressant activity of a single intragastric administration of SJJY was evaluated by conducting the TST, FST, and SLAT. (2) Olfactory bulbectomized (OB) model experiment. Mice were divided into the sham-operation group, the model group, the duloxetine (10 mg/kg) group, and the SJJY groups (534.8 and 1 069.5 mg/kg). Duloxetine and SJJY were administered intragastrically for 15 days. The coat state test (CST), SLAT, and TST were conducted to evaluate the antidepressant activity of SJJY when administered multiple times, and ELISA was used to detect the levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in hippocampal tissues. Western blotting was conducted to determine the hippocampal expression levels of caspase-3(CASP3) and post synaptic density 95(PSD-95).Results(1) In the behavioral despair experiment, a single dose of SJJY (1 069.5 mg/kg) or duloxetine (10 mg/kg) significantly shortened the suspension immobility time (P<0.01), and a single dose of SJJY (267.4, 534.8, or 1 069.5 mg/kg) or duloxetine (20 mg/kg) significantly shortened the swimming immobility time (P<0.05). These effective doses had no excitatory or inhibitory effect on the central nervous system. (2) In the OB model experiment, compared with the model group, administration of SJJY (1 069.5 mg/kg) reversed OB-induced elevated spontaneous activity, increased the TST immobility time, decreased the coat state score (all P<0.05), upregulated hippocampal MDA levels, downregulated SOD levels (both P<0.05), upregulated hippocampal CASP3 protein levels, and downregulated PSD-95 protein levels (both P<0.05).ConclusionSJJY has antidepressant activity. Its mechanism of action may be related to oxidative stress, anti-hippocampal apoptosis, and enhanced synaptic plasticity.关键词：Sangju Jieyu Formula;homology of medicine and food;antidepressant;behavioral despair model;olfactory bulbectomized model;oxidative stress;apoptosis;mice
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发布时间：2023-11-06 - 摘要：ObjectiveTo investigate the effect and mechanism of Kangxi Yixin Formula (KYF) on cardiomyocyte mitochondrial dynamics and apoptosis in mice with dilated cardiomyopathy (DCM).MethodsAccording to the random number table method, 40 cTnTR141W transgenic DCM mice were randomly divided into the model group, the KYF low-dose group (2.7 g/kg), the KYF high-dose group (5.4 g/kg), and the captopril group (10.1 mg/kg), with 10 mice per group. Another 10 C57BL/6J mice were set up as the normal group, and each group was administered intragastrically for 8 weeks, respectively. Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), ejection fraction (EF), and reduction rate (FS) were determined using a small animal ultrasound instrument. Myocardial pathology was observed by HE staining. The ultrastructure of myocardial mitochondria was observed by transmission electron microscope. Apoptosis of cardiomyocytes was detected by the TUNEL method. The content of ROS was detected using a fluorescent probe. The expression levels of MFN2, OPA1, DRP1, FIS1, Bax, Bcl-2, and Caspase-3 were detected by Western blotting.ResultsCompared with the normal group, LVESD and LVEDD were increased, and FS and EF were decreased in the model group (P<0.05), myocardial injury was obvious, mitochondrial disarrangement and swelling were accompanied by vacuole-like changes, the proportion of apoptotic cells was increased, the content of ROS was increased, the protein expression levels of the mitochondrial fusion proteins MFN2 and OPA1 and the anti-apoptotic factor Bcl-2 were decreased, and the expression levels of the mitochondrial fission proteins DRP1 and FIS1 and apoptotic factors Bax and Caspase-3 were increased (P<0.05). Compared with the model group, LVESD and LVEDD were decreased, FS and EF were increased (P<0.05), myocardial injury was alleviated, mitochondrial disarrangement and swelling were alleviated, the proportion of apoptotic cells was reduced, the content of ROS was reduced, the protein expression levels of Bcl-2, MFN2, and OPA1 were increased, and the protein expression levels of Bax, Caspase-3, DRP1, and FIS1 were decreased (P<0.05) in the KYF low- and high-dose groups.ConclusionKYF inhibits cardiomyocyte apoptosis and improves cardiac function in DCM mice, and its mechanism of action may be related to regulating mitochondrial dynamic balance.关键词：Kangxian Yixin Formula;dilated cardiomyopathy;cardiomyocyte;apoptosis;mitochondrial dynamics;mice
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发布时间：2023-11-06 - 摘要：ObjectiveWe aimed to investigate the inhibitory effect of serum containing Huangqi Jianzhong Decoction on isoproterenol (ISO) induced lipolysis and browning in 3T3-L1 adipocytes and its relationship with the regulation of the cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/cyclic adenosine monophosphate response element binding protein (CREB) signaling pathway by brain and muscle aromatic hydrocarbon receptor nuclear transcription factor like protein-1 (BMAL1).MethodsBlank serum and Huangqi Jianzhong Decoction drug-containing serum were prepared. 3T3-L1 adipocytes were cultured in vitro and induced to differentiate and mature. They were divided into the control group, the blank group, the 2.5% drug-containing serum group, the 5% drug-containing serum group, and the 10% drug-containing serum group. 10 mmol/L ISO was given to all groups except for the control group to establish the hypertipolysis and browning model. Oil red O staining and enzyme-linked immunosorbent assay (ELISA) were used to detect the lipid droplet positive area ratio and the content of hydrolyzed products. Real-time PCR and Western blotting were conducted to detect the expression of lipolysis- and browning-related genes and proteins, respectively, to select the optimal volume fraction of drug-containing serum for the lentivirus transfection experiment. Mature adipocytes were transfected with si-BMAL1 to silence BMAL1. Control cells were transfected with si-NC. Then the cells were divided into the si-NC group, the containing serum si-NC group, the si-BMAL1 group, and the drug-containing serum si-BMAL1 group. After incubation with ISO, the lipid droplet positive area ratio in adipocytes was detected by oil red O staining. The contents of triglyceride (TG) and cAMP in adipocytes and free fatty acid (FFA) in medium were detected by ELISA. The protein expression levels of PKA and CREB were determined by Western blotting. The mRNA expression levels of hormone-sensitive lipase (HSL), triglyceride lipase (ATGL), uncoupling protein 1 (UCP1), and T-box transcription factor 1 (TBX1) were determined by real-time PCR.ResultsCompared with the 2.5% and 5% drug-containing serum groups, the contents of cAMP in adipocytes and FFA in culture medium were decreased (P<0.05), the content of TG was increased (P<0.05), the protein expression of PKA was decreased (P<0.05), and the mRNA expression levels of HSL and ATGL were decreased (P<0.05) in the 10% drug-containing serum group. The relative protein expression of BMAL1 was significantly lower in 3T3-L1 adipocytes transfected with si-BMAL1 than in the si-NC group (P<0.05), indicating that BMAL1 was successfully silenced. Compared with the si-NC group, the lipid droplet positive area ratio and TG content were decreased in the si-BMAL1 group (P<0.05), while the FFA content in culture medium, cAMP content in adipocytes, and PKA and CREB protein expression levels were increased (P<0.05), and the mRNA expression levels of HSL, ATGL, UCP1, and TBX1 were also increased (P<0.05). Compared with the si-BMAL1 group, the lipid droplet positive area ratio and TG content were increased in the drug-containing serum si-BMAL1 group (P<0.05), while the content of FFA in culture medium, the content of cAMP in adipocytes, and the protein expression levels of PKA and CREB were significantly decreased (P<0.05) and the mRNA expression levels of HSL, ATGL, UCP1, and TBX1 were also decreased (P<0.05).ConclusionDrug-containing serum Huangqi Jianzhong Decoction can inhibit ISO-induced lipolysis and browning in 3T3-L1 adipocytes, the mechanism of action may be related to the regulation of the cAMP/PKA/CREB signaling pathway by BMAL1.关键词：Huangqi Jianzhong Decoction;cachexia;fat consumption;BMAL1;cAMP/PKA/CREB signaling pathway;rats
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发布时间：2023-11-06
Experimental Studies
- 摘要：Phlegm-dampness constitution is the common soil for a variety of metabolic diseases such as obesity and hyperlipidemia. Most physicians attribute all metabolic functions to the spleen. However, metabolism is also closely related to the small intestine. The theory of "small intestine separating purity from turbidity" summarizes functions of absorption, digestion, and excretion of water and food by the small intestine. Our team propose that small intestine dysfunction is an essential pathological factor in the development of lipid metabolism disorders in phlegm-dampness constitution individuals. However, its molecular mechanism is not clear. The theory of "small intestine separating purity from turbidity" has the same scientific connotation as the function of Niemann-Pick C1-like 1 (NPC1L1), which regulates lipid absorption and transportation. This paper provides a new interpretation of the "small intestine separating purity from turbidity" theory from the perspective of NPC1L1. The close association between "small intestine separating purity from turbidity" and metabolic disorders is confirmed. Yiqi Jianyun Decoction is effective for metabolic disorders of phlegm-dampness constitution individuals, and the herbs in this formula have been found biologically effective in regulating NPC1L1 expression. Thus, NPC1L1 regulating lipid absorption provides a new target for traditional Chinese medicine treatment method based on the theory of "small intestine separating purity from turbidity", enriching the modern scientific connotation of the medicinal mechanism of Yiqi Jianyun Decoction and providing a new theoretical basis and ideas for the clinical management of metabolic diseases and adjustment of phlegm-dampness constitution.关键词：phlegm-dampness constitution;small intestine separating purity from turbidity;Niemann-Pick C1-like 1;metabolic disorder;Yiqi Jianyun Decoction
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发布时间：2023-11-06 - 摘要：The aim of constructing the prescription-individual identification method is to establish the internal connection between "naming the individual according to the prescription" and "applying the prescription according to individual differentiation" to attach dual connotations to constitutional characteristics and prescription applications, and to develop the mode of diagnosis and treatment of "the prescription and individual integration." The article first elaborates that "prescription application in accordance with constitution differentiation" is the theoretical basis for the prescription-individual identification method. It discusses that the principle of "applying the prescription according to individual differences" should be targeted, long-lasting, stable, and safe. Then we analyze the method of constructing "prescription-individual identification" from four aspects: physical structure, physiological function, psychological state, and adaptability. Based on the four different health states of no disease, before disease, during disease, and after disease, we explore the application of the prescription-individual identification. The article summarizes the three "easy to" characteristics of the prescription-individual identification method: easy to understand constitutional characteristics, easy to grasp the key points of constitutional differentiation, and easy to apply constitutional adjustment prescription. It is believed that the construction of the prescription-individual identification method has important theoretical and practical value for integrating the advantages of Constitution and Formulas of traditional Chinese medicine, enriching the diversified diagnosis and treatment models of traditional Chinese medicine, and implementing the strategy of preventive treatment of diseases.关键词：applying prescription based on constitution differentiation;relation of prescription and constitution;prescription-individual identification;prescription-individual integration
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发布时间：2023-11-06
TCM Constitutions
- 摘要：ObjectiveWe aimed to find the distribution rule of traditional Chinese medicine(TCM) patterns of schizophrenia patients from the result of a large-sample, multicenter, cross-sectional study.MethodsFrom May 2020 to April 2021, we recruited schizophrenic patients in the following 12 sub-centers in Beijing: The Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine, The Third Hospital of Chaoyang District, Beijing Anding Hospital of Capital Medical University, Beijing Huilongguan Hospital, Daxing Xinkang Hospital, Changping Hospital of Integrated Chinese and Western Medicine, Shijingshan Mental Health Care Institute, Chuiyangliu Hospital of Tsinghua University, Yanqing District Psychiatric Hospital, Pinggu District Psychiatric Hospital, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, and Dongzhimen Hospital of Beijing University of Chinese Medicine. In total, 4, 734 schizophrenic patients(2, 529 men and 2, 205 women with an average age of 50.81 years) were included, and their mental symptoms were evaluated using the TCM Pattern Scale, Positive and Negative Syndrome Scale, and the four diagnostic method (inspection, listening and smelling, inquiry, and palpation and pulse taking). After finishing the Schizophrenic TCM Pattern Observation Form, the distribution of the patients′ TCM patterns was analyzed through the following steps: (Ⅰ) building a network diagram of all symptoms to extract the pattern locations and elements using association rules; (Ⅱ) combining the pattern locations with the pattern elements to form basic pattern, using the method of association rules, and Bayesian network, cluster analysis; and (Ⅲ) summarizing the patterns according to TCM theories and TCM expert consensus, and selecting the same patterns as the patterns of schizophrenia.ResultsAssociation rules were used to construct a relationship network diagram of 162 symptoms, and 16 basic TCM pattern were extracted. Among them, (Ⅰ) association rules extracted nine TCM patterns(phlegm-fire disturbing mind, hyperactivity of heart-liver fire, stagnation of qi and blood stasis, hyperactivity of fire due to yin deficiency, kidney deficiency and liver depression, spirit confused by phlegm, yang deficiency of the spleen and kidney, deficiency of both the heart and spleen, and phlegm-qi stagnation with binding); (Ⅱ) cluster analysis extracted nine patterns(hyperactivity of heart-liver fire, phlegm fire burning yin, stagnation of qi and blood stasis, yin deficiency and blood insufficiency, yang deficiency of the spleen and kidney, stagnation of phlegm-dampness, deficiency of both the heart and spleen, deficiency of kidney qi, and deficiency of bile qi); and (Ⅲ) the Bayesian network extracted 11 patterns(phlegm-fire disturbing mind, hyperactivity of heart-liver fire, hyperactivity of fire due to yin deficiency, stagnation of qi and blood stasis, intermingled phlegm and heat, kidney deficiency and liver depression, spirit confused by phlegm, deficiency of both the spleen and kidney, deficiency of both the heart and spleen, disharmony between the heart and kidney, and liver-kidney deficiency). Finally, eight common patterns were summarized, including phlegm-fire disturbing mind, hyperactivity of heart-liver fire, stagnation of qi and blood stasis, hyperactivity of fire due to yin deficiency, spirit confused by phlegm, deficiency of both the heart and spleen, yang deficiency of the spleen and kidney, and kidney deficiency and liver depression.The clinical features of schizophrenic patients included negative symptoms(2, 893 cases, 61.11%) and positive symptoms(1, 841 cases, 38.89%). The former belongs to the TCM "epilepsy syndrome" category, and the patterns of yang deficiency of the spleen and kidney(22.94%), spirit confused by phlegm(17.79%), deficiency of both the heart and spleen(13.98%), and kidney deficiency and liver depression(6.40%) are involved. The latter belongs to the TCM "manic psychosis syndrome" category, and the patterns of phlegm-fire disturbing mind(12.63%), stagnation of qi and blood stasis(11.03%), hyperactivity of fire due to yin deficiency(10.25%), and hyperactivity of heart-liver fire(4.99%) are involved.ConclusionThis study may provide a reliable basis for forming plans for TCM diagnosis and treatment of schizophrenia, which can be guided by the 8 TCM patterns from 4.734 patients.关键词：Schizophrenia;TCM patterns;association rules;Bayesian network;cluster analysis
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发布时间：2023-11-06 - 摘要：ObjectiveWe aimed to evaluate the clinical efficacy and safety of Luofushan Rheumatic Plaster in the treatment of rheumatoid arthritis(RA) combined with wrist inflammation.MethodsA multicenter, block-randomized, double-blind, placebo-controlled clinical trial was conducted including 180 patients with RA combined with wrist tenosynovitis and/or synovitis from eight hospitals who were randomly divided into the Luofushan group (90 cases) and the control group (90 cases). Patients in both groups were given basic treatment such as disease-modifying antirheumatic drugs (DMARDs). Patients in the Luofushan group were given Luofushan Rheumatic Plaster, while patients in the control group were given Luofushan Rheumatic Plaster simulant. The core trial duration was 4 weeks, and the extended trial was conducted in three centers (participants could voluntarily choose to continue to receive Luofushan Rheumatic Plaster for an additional 4 weeks). Follow-up of local symptoms of the wrist joint (VAS score, swelling degree, duration of morning stiffness), bilateral wrist joint ultrasound (tenosynovitis, synovitis, synovial hyperplasia), overall evaluation of disease (DAS28-CRP score, Health Assessment Questionnaire Disability Index [HAQ-DI], and Chinese Patient-Reported Activity Index with Rheumatoid Arthritis [CPRI-RA] ), and erythrocyte sedimentation rate(ESR)was conducted one or two times, and skin irritation and adverse events during the experiment were recorded. Effectiveness was analyzed using the per-protocol set, and the safety indicators were analyzed using the safety set.ResultsCompared to pre-treatment, adjuvant therapy with Luofushan Rheumatic Plaster for 4 weeks can improve the VAS score (P<0.05), the degree of swelling (P<0.05), morning stiffness duration (P<0.05), wrist tenosynovitis (P<0.05), synovitis (P<0.05), DAS28-CRP (P<0.05), HAQ-DI(P<0.05), and CPRI-RA(P<0.05), but there were no statistically significant difference compared to the control group. Compared to the control group, pain was alleviated in the Luofushan group after 8 weeks of treatment(P<0.05). Compared to pre-treatment adjuvant therapy for 8 weeks can provide additional improvement in the synovial hyperplasia of the wrist joint (P<0.05), and the ESR level (P<0.05), but there were no statistically significant difference compared to the control group. There was no increase in the incidence of skin irritation and adverse events between the two groups (P > 0.05).ConclusionLuofushan Rheumatic Plaster has a definite analgesic effect in the treatment of wrist rheumatoid arthritis, and it improves ultrasound imaging result, the degree of joint swelling, and ESR. Moreover, it is safe and suitable for long-term clinical use.关键词：rheumatoid arthritis;tenosynovitis;synovitis;randomized controlled trial;Luofushan Rheumatism Plaster
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发布时间：2023-11-06 - 摘要：Premature ejaculation is characterized by ejaculation at the beginning of sexual intercourse, or even before sexual intercourse, and an inability to engage in normal sexual activity. The basic pathogenesis of premature ejaculation is a disquieted heart spirit, and calming the heart and tranquilizing the mind is an important treatment method for this condition. The efficacy of traditional Chinese medicine(TCM) in calming the heart and tranquilizing the mind to treat premature ejaculation has been recognized in clinical practice, but the specific mechanism of action is not yet fully understood. Based on the theory of TCM and molecular biology research, it has been found that abnormal 5-hydroxytryptamine (5-HT, also known as serotonin) metabolism in the central nervous system is closely related to the disquieted heart spirit syndrome of TCM. In the central nervous system, 5-HT plays an important role in the occurrence and development of premature ejaculation. With the development of high-throughput sequencing technology, it has been found that the gut microbiota can participate in the synthesis of 5-HT in the central nervous system. Gut microbiota disorder is likely to be a promoting factor in the pathogenesis of premature ejaculation, and herbs that calm the heart and tranquilize the mind can indirectly or directly affect the level of 5-HT in the brain by regulating the gut microbiota, which may be one of the mechanisms by which they prevent premature ejaculation. Therefore, this paper discusses the mechanism by which herbs that calm the heart and tranquilize the mind can treat premature ejaculation from the perspective of gut microbiota. Our study supports the application of TCM in the treatment of premature ejaculation.关键词：gut microbiota;5-hydroxytryptamine;premature ejaculation;calming the heart and tranquilizing the mind;mechanism of action
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发布时间：2023-11-06 - 摘要：Depression is a psychosomatic disease with a yearly increasing incidence. Western medicine has not reached an agreement on its etiology and pathological mechanism, and many hypotheses have been proposed, such as monoamine neurotransmitter deficiency, intestinal flora imbalance, and hypothalamic-pituitary-adrenal axis dysfunction. Clinical treatment method are dominated by antidepressants. Based on the qi-collaterals theory, this study points out that this disease is caused by a lack of brain collaterals nourishment, qi deficiency, liver collaterals stagnation, and disharmony between qi and collaterals. The principles of treatment are relieving the deficiency of collaterals, tonifying qi and nourishing the brain collaterals, unblocking collaterals with pungent flavor, soothing the liver and regulating qi, regulating spirit and eliminating pathogenic factors, treating zang-fu organs, and harmonizing qi and collaterals. Our ultimate aim is to improve the treatment of depression by further elucidating its pathogenesis.关键词：qi-collaterals theory;depression;liver collaterals stagnation;lack of brain collaterals nourishment
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发布时间：2023-11-06
Clinical Studies
- 摘要：The characteristics and advantages of traditional Chinese medicine (TCM)in the treatment of acute leukemia were comprehensively reviewed through the study and analysis of relevant literatures in China and abroad. Chinese and foreign literatures published from January 1, 2012 to December 31, 2022 were searched in China National Knowledge Infrastructure and PubMed database. The result showed that the therapeutic mechanism of TCM for acute leukemia is related to multiple links such as chemotaxis, adhesion, migration, degradation, stromal survival. Through the analysis of cell, gene and proteomics, the therapeutic mechanism and multi-targets of TCM in the treatment of leukemia were confirmed. In the overall program of TCM treatment of leukemia, the unit therapy is still the standard program for the treatment of acute leukemia. TCM has unique advantages in different treatment units of chemotherapy period, myelosuppression period, myeloremission period and no chemotherapy (TCM therapy alone) period. In the treatment of refractory acute leukemia, TCM can improve the rate of bone marrow remission and prevent the related complications caused by rotation regimen or dosage-increasing of anticancer drugs, all of which have obvious effects. Therefore, TCM treatment of leukemia can reduce toxicity, increase efficacy, protect organs, improve the quality of life, and prolong survival, which has become a focus of current research.关键词：Acute Leukemia;traditional Chinese medicine;characteristics and advantages
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发布时间：2023-11-06 - 摘要：Aplastic anemia is a bone marrow hematopoietic failure disease, characterized as a decrease in bone marrow hematopoietic stem cells and pancytopenia. This disease belongs to the categories of "blood syndrome", "deficiency and fatigue", "marrow necrosis", and "blood deficiency" in traditional Chinese medicine. In recent years, the incidence rate of aplastic anemia has gradually increased, but the existing western medicine treatment methods are limited, with poor long-term efficacy and larger adverse reactions. Conversely, traditional Chinese medicine has unique advantages in the treatment of this disease. The traditional Chinese medicine treatment of aplastic anemia began in the 1950 s and has developed for more than 70 years. Through the exploration of many physicians theory and practice, the basic treatment principles have gradually been formed, with tonifying the kidney as the core strategy, and with strengthening the spleen and replenishing qi, activating blood circulation for removing blood stasis, purging fire and regulating the liver, and dispelling phlegm as auxiliary strategies. This article summarizes the theoretical origin, evolution of syndrome types, treatment research, and experimental progress of traditional Chinese medicine in the treatment of aplastic anemia, and puts forward suggestions for the existing problems in order to contribute to the development of traditional Chinese medicine in the treatment of aplastic anemia.关键词：chronic aplastic anemia;traditional Chinese medicine;research progress
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发布时间：2023-11-06 - 摘要：The proper functioning of the human hematopoietic system is closely regulated by the bone marrow microenvironment. The destruction and injury of the bone marrow microenvironment by leukemia stem cells are closely related to the attack, drug resistance, and additional pathological processes of leukemia. This article explores the traditional Chinese medicine (TCM) theory of "turbid evils invading the clear orifice" and further expands the meaning of "turbid" and "clear". According to TCM, the deficiency of healthy qi causing the invasion of turbid evils into the clear marrow is the primary phthogenesis of leukemia. This result in the external spreading of turbid evil in the marrow, the retention of turbid pathogen in the clear marrow, and other pathogenic factors. Based on the above theory, the principle of TCM differentiation and treatment for leukemia should focus on reinforcing healthy qi, resolving toxins and restoring the clear orifice. To remove the evil from the marrow, treatment should involve detoxification, marrow clearance, and harmonization method, while also reinforcing healthy qi to restore the normal function. TCM has shown good effects throughout the entire process of leukemia treatment, but more clinical and basic research is still needed to establish and expand the unique advantages of TCM.关键词：leukemia;turbid evils invading the clear orifice;bone marrow microenvironment;turbid evils
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发布时间：2023-11-06
Hematology and Oncology
- 摘要：ObjectiveTo investigate the effects of baduanjin on the body mass index (BMI) and temperature of the abdomen and commonly used weight-loss acupoints in healthy person using infrared thermal imaging and the meridian and acupoint theory of traditional Chinese medicine.MethodsA total of 120 healthy individuals from Beijing were enrolled as participants, and were randomly divided into the experimental group, control group, and blank group at a 1: 1: 1 random number table method. During the course of the study, 13 individuals dropped out, leaving a total of 107 participants who completed the intervention. The experimental group (n=36) received baduanjin exercise intervention, the control group (n=35) received calisthenics intervention, and the blank group (n=36) received no exercise intervention. The duration of intervention was 12 weeks. Before enrollment and after the 12-week intervention, BMI was measured by a professional body fat scale, and the temperature of the abdomen, bilateral Tianshu (ST25), bilateral Zusanli (ST36), Zhongwan (CV12), and Guanyuan (CV4) were detected by infrared thermal imaging. The changes of the three groups before and after intervention were compared, and the mediation effect test was conducted.ResultsAfter the intervention, there was no significant difference in BMI among the three groups. However, the experimental group exhibited significantly higher temperatures of the abdomen, bilateral Tianshu (ST25), and Zhongwan (CV12) compared with the other two groups (P<0.05, P<0.01). Within-group analysis showed a significant decrease in BMI in the experimental group (P<0.01) and significant increases in temperatures of the abdomen, bilateral Tianshu (ST25), and Zhongwan (CV12) (P<0.01). Mediation effect analysis revealed a significant mediating effect of Zhongwan (CV12) and the left Tianshu (ST25) in the elevation of abdominal temperature induced by baduanjin exercise.ConclusionBaduanjin can effectively reduce BMI and the risk of obesity. Additionally, it can increase abdominal temperature and promote metabolism, possibly through the activation of the Tianshu (ST25) and Zhongwan (CV12) acupoints, thereby regulating visceral functions.关键词：baduanjin;body mass index;infrared thermal imaging;acupoint
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发布时间：2023-11-06
Acupuncture Moxibustion and Tuina
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